SUMMER WEEK REGISTRATION FORM

 * indicates required field.
   Name *
Address *
     City * State * Zip *

Phone [Day]:    Phone [Night]:
E-Mail: *

Má tá suim agat iontráil ar scrúdú an fháinne, déan marc anseo.
Please check if you are a first time attendee or if you are updating ANY contact information.
Please Note - You will be asked to provide an emergency contact name and telephone number upon arrival.
Age if under 16 years old
Where do you study?
Teacher's Name
Not counting breaks, how long have you been studying Irish (Years) (Months)
Place an [X] if you are: Self-taught?    Schooled in Ireland?    A Native Speaker?
Using the guide below, how would you rate your level of Irish? Please give ONE number, not a range.
1 = True Beginner
2-3 = Some study, but still a beginner
4-6 = Intermediate and can converse some
7 = Somewhat Fluent
8-9 = Good Fluency
10 = Very Readily Fluent and/or Native Speaker

Please place an [X] beside the statements below that best reflect your Irish Language level.
Total Beginner
Only odd words & phrases
Can understand and speak just a bit
Can read and write just a bit
Can have only a very simple conversation
Can coverse for a few minutes, with much effort
Can readily converse for 5-10 minutes
Fluent, but grammar is weak
Cainteoir Líofa
Cainteoir dúchais

PAYMENT

Adults - $325.00
Under 16 - $160.00
Adult Day Students - $175.00 (includes lunch & dinner)

Naíonra Only - $100.00 (9am - 3pm; includes lunch)

You can register on the Web and pay by credit/debit card or print out this form and pay by check or money order.

Register on Web with Credit/Debit Card and PayPal

Print Form and Pay by Check:
make your check payable to: Daltaí na Gaeilge and mail it to:
Daltaí na Gaeilge
Liam Guidry
279 Park Ave.
Elberon, NJ 07740

Questions?

Contact Ethel Brogan
(845) 897-5457
Information and Directions
Events
February Weekend | Teachers Workshop | Advanced Speakers Weekend
May Weekend | June - Irish Saturday | Summer Week
November Weekend

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